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SHANE WILBURN PA-C
NPI 1669178075
Physician Assistant in Summerville, SC

Active since February 07, 2023PECOS EnrolledAccepts Medicare Assignment
89 OLD TROLLEY RD STE 102, SUMMERVILLE, SC 29485(854) 206-5513(854) 246-8965 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Wilburn Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE WILBURN PA-C (NPI 1669178075) is an individual physician assistant in Summerville, South Carolina and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS, is affiliated with Roper Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1669178075
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSHANE WILBURNCredential: PA-C
Location Address89 OLD TROLLEY RD STE 102Summerville, SC 29485-4951
Mailing Address111 Rowboat RdSummerville, SC 29486-6900 · (419) 689-2923
Phone(854) 206-5513
Fax(854) 246-8965
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 7, 2023
Last NPPES UpdateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1669178075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
89 OLD TROLLEY RD STE 102, Summerville, SC 29485
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shane Wilburn Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426421785
PECOS Enrollment IDI20231004000158
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
279 services164 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
66 services51 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
59 services52 patients
Injection, ketorolac tromethamine, per 15 mg J1885
Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.
55 services14 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
42 services35 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
34 services25 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Roper Hospital

Acute Care Hospitals · Charleston, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420087
Location316 Calhoun StCharleston, SC 29401 · Charleston County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29485 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Wilburn's NPI number?

The NPI number for Shane Wilburn is 1669178075. It was assigned to this individual provider in the NPPES registry on February 7, 2023.

Where is Shane Wilburn located?

Shane Wilburn practices at 89 Old Trolley Rd Ste 102, Summerville, SC 29485. The listed phone number is (854) 206-5513.

What is Shane Wilburn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Shane Wilburn enrolled in Medicare?

Yes. Shane Wilburn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shane Wilburn accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare and 1 other insurer list Shane Wilburn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shane Wilburn affiliated with any hospitals?

According to CMS data, Shane Wilburn is affiliated with Roper Hospital.

When was this NPI record last updated?

The NPPES record for Shane Wilburn was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.